The Last Resort for Severe OAB Condition

This last article focuses on the 3rd line of treatment for Overactive Bladder (OAB): invasive treatments. Currently, there are different options available: sacral nerve modulation, posterior tibial nerve stimulation, botox injections, and bladder surgery. Although these options are effective, they are still considered as a last resort, only when there is no response to behavioral lifestyle changes, and oral medications. Below you can read why.


The human bladder is controlled by a set of nerves. The first group of invasive treatments entails stimulation of these nerves supplying the urinary bladder. For OAB patients, the most common nerve stimulation treatments are sacral nerve stimulation and posterior tibial nerve stimulation:


  1. In sacral nerve stimulation (sacral nerve modulation), a device is implanted into the patient’s lower back, which sends impulses to the sacral nerve, responsible for controlling the bladder function. The biggest problem with such a device is that it does not work for every patient and can cause infection and / or skin irritation. Besides, device malfunction is also a risk, and patients need to be careful when operating power tools.
  2. In tibial nerve stimulation, a thin needle is placed behind the patient’s ankle where the tibial nerve is. Its stimulation blocks abnormal signals from the bladder to prevent bladder spasms. It can take up to twelve weeks to show results. Therefore, the treatment requires patients to have weekly visits for twelve weeks. After that, patients are required to visit their doctors once per month. Like other invasive treatments, tibial nerve stimulation can also have side effects, such as tingling, bruising, bleeding, and infection at the needle site.


The third type of invasive treatment involves giving a series of Botox injections into the bladder muscle. The use of Botox is widely spread, as it can be used for a variety of treatments nowadays, such as bladder control. Botox is a well-established treatment for OAB, where a series of injections are inserted into the bladder muscle. When Botox is injected, it treats the thick muscle bands typically present in conditions that cause bladder overactivity. Side effects of Botox therapy include bleeding in the urine or a urinary tract infection. The treatment is not permanent, and in order to maintain clinical impact, it is necessary to repeat the injections periodically. 


The last and most invasive type of treatment for OAB is surgery, where two different surgeries are possible. In the first one, surgery is performed to increase capacity of the urinary bladder. The procedure involves using pieces of the intestine to replace a portion of the bladder. However, the patients may have to use a catheter intermittently to empty the bladder for the rest of their lives. The second surgery is bladder removal and is usually performed as the last resort. This option entails extensive surgical intervention to construct a replacement bladder or an opening in the body to attach a bag to the skin to collect urine.


To sum up, invasive treatments are the last resort for OAB patients and are used when none of the other treatment works. They can be effective, but on the downside, they can be dangerous and still not be able to give the best quality of life that every patient deserves. Therefore, Inura has developed a solution to this unmet medical need. Have you already heard about the ovulum of Inura? Stay tuned to our blog because we are going to speak about our solution very soon!


About Inura Medical

Inura Medical AG (“Inura”) is a Swiss start-up company with a clear vision to make a difference in women’s health. Inura’s product is an innovative, first-of-a-kind “urethral ovulum” that utilizes a novel route of drug administration to treat diseases of the bladder and lower urinary tract. Inura’s technology results from decades of work in urology by Professor Grant S. Mulholland, a renowned surgeon, academic, and past President of the American Urology Association. The first indication we are addressing with the ovulum is a chronic disease, named overactive bladder (OAB). More details on